Perforated appendicitis with abscess formation

Case contributed by Ammar Haouimi
Diagnosis almost certain


10 days history of right lower abdominal pain with tenderness, fever and leukocytosis.

Patient Data

Age: 25 years
Gender: Female

The appendix is dilated with the thick enhanced wall. A focal defect is noted at the appendiceal tip, containing appendicoliths with an adjacent large lobulated collection with air-fluid level and thick enhanced wall, surrounding mesenteric fat stranding and reactive lymph nodes enlargement. Thickening with enhancement of the adjacent peritoneal reflections. Moderate free intraperitoneal fluid around the liver, paracolic gutters and pelvic region.

Reactive thickening of the terminal ileum, cecum and sigmoid colon.

Case Discussion

CT features of perforated appendicitis with a large abscess formation, peritonitis and reactive thickening of the terminal ileum, cecum and sigmoid colon that was confirmed at surgery.

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